Updated: Sep 22, 2020
I’ve never been what I would consider to be a heavy drinker, but I must admit that I have always enjoyed sharing a few drinks with family and friends. With summer on the horizon and day light extending once again in New Zealand, social gatherings will no doubt be occurring more frequently. For some, that translates in an increased likelihood of sharing a drink as well. Although my Weird Wonderful Brain can’t handle social gatherings really well anymore, I still make an effort to join in whenever I can. Apart from the usual brain injury challenges linked to social gatherings, there is another aspect that I need to consider...alcohol or alcohol free?
It is an accepted custom in our society to have social drinks and a part of me really enjoys getting in on the bandwagon too. However, since encephalitis and brain injury, I have avoided consuming any amount of alcohol. There are a few reasons for this. Firstly, I feel spaced out most of the time so it tends to make things like following a conversation or simply keeping my balance much harder. On top of the heighten cognitive deficits, I have also noticed that on the rare occasions where I have consumed 2-3 drinks (which is still not a huge amount), the resulting physical effects have been pretty drastic. Alcohol seems to trigger my heart rate to increase considerably, I get loads of ectopic heart beats, I can feel extremely nauseous, I sweat profusely, it can trigger massive headaches and my tummy seems to get all tangled up.
I found that the cognitive and physical effects of alcohol post brain injury last long after my last drink and will often carry on throughout the night...stopping Sandman from stealing me away for some very well deserved and necessary sleep. Once you add the lack of sleep on top of a social event and a few drinks, it doesn’t take too long for the brain to spiral out of control.
Effects of alcohol on the brain
That led me into conducting a bit of research about the “effects of alcohol on the brain”. From past personal experience, most of us are aware that alcohol, even if consumed at a recreational level, can alter our senses, bodily functions and cognitive functioning. Although they are likely to be temporary effects, alcohol can indeed slow our reaction time, alter or thinking and decision making process, trigger a loss of inhibition, induce blurry vision, impair our memory, slur our speech, muck up our balance, coordination and mobility and when consumed in excess, alcohol can even trigger black outs and cause us to be sick. From that list of ways in which a brain is affected by alcohol, I can already identify several cross-overs with how my Weird Wonderful Brain has been affected by the acquired brain injury. Some of those effects are present in spite of me being alcohol free so I was keen to dig further to better understand how an injured brain is likely to be further impacted.
Effects of alcohol on an injured brain
There are bits and pieces of information out there on brain injury and alcohol use, but to my surprise, there wasn’t a huge amount. The sources that I found had a theme in common which is, because alcohol affects the central nervous system, people with a brain injury “are likely to experience even greater problems with alertness, memory, problem-solving, and controlling their behaviour and emotions.”
I eventually landed on the MSKTC website which provides a very interesting fact sheet in regards to brain injury and alcohol use. The following facts  were taken directly from their website and were the ones that resonated the most with me:
Alcohol slows down or stops brain injury recovery.
Not drinking is one way to give the brain the best chance to heal.
People's lives often continue to improve many years after brain injury. Not drinking will increase the chance of improvement.
Not drinking can reduce the risk of developing seizures.
Drinking alcohol puts survivors at an even higher risk of having a second brain injury. This may be because both brain injury and alcohol can affect coordination and balance.
Not drinking can reduce the risk of having another brain injury.
Alcohol may affect brain injury survivors more than it did before their injury.
Alcohol magnifies some of the cognitive problems caused by brain injury.
Not drinking is one way to keep your mental abilities at their best and stay sharp and focused.
There was also very useful information relating to alcohol and depression. It is proven that people suffering from a brain injury are already at a greater risk of developing a form of mental illness such as depression. Alcohol being a known depressant, it could also cause or worsen symptoms of depression. Therefore, keeping alcohol out of the equation could improve your chances of keeping depression at bay or at least improve your chances of better managing it.
Post brain injury, you may also need to be aware of how alcohol can affect your current medication. In some cases, it can decrease or stop their effectiveness and in others, it may increase their effectiveness and potential side effects. It is therefore another aspect that needs to be weighted very carefully when making decisions regarding alcohol consumption post brain injury.
During my research, I unfortunately didn’t find much relating to how the consumption of alcohol by a brain injury survivor can impact the heart rate. However, once I took the words brain injury out of the equation, I found many ways in which alcohol can affect the cardiovascular system e.g: increased heart rate, high blood pressure, weakened heart muscle and irregular heartbeat. Although they aren’t symptoms that I experienced prior to my acquired brain injury, they are very much present now and it demonstrates clearly how my body's tolerance to alcohol has been impacted...even if consumed at a very low level. I can only assume that the changes in my brain pathways following the encephalitis must have tweaked how the heart electrical system works...making me more prone to temporary arrhythmia perhaps? All I know is that it is an uneasy feeling to experience. I feel my heart pounding and racing in my chest and I can even hear my heart pulsing in my ears as if music was playing in the background...it makes me feel absolutely terrible.
What have I learnt?
From all my readings, it simply seems that a person living with a brain injury is generally more sensitive to alcohol. We generally have less tolerance to alcohol and are at greater risk of experiencing many of its undesirable side effects even if consumed in a much smaller quantity. The payback is also likely to last much longer compared to the average person given all the other factors that brain injury survivors have to take into consideration. Since encephalitis, I’ve had many friends ask questions regarding alcohol consumption and brain injury which I’m always more than happy to answer. However, I’ve also heard the rare but insensitive comment “Oh aren’t you going to have a drink with us to celebrate such and such person’s birthday”...as if drinking alcohol was a way to show someone that you care, as if it was a must to have a great time. Sometimes I wish that people would remember that part taking in a social event already comes with additional challenges for me and that my brain is foggy enough in the best of times. However, I generally brush those comments off pretty easily...I'm happy to let them hold on to whatever perception they might have. Deep down, I know that the people who truly matter to me don’t care whether I share an alcoholic drink with them or not. The ones who truly care will simply appreciate me being there and that’s good enough for me.
The reality is that post brain injury, there are no level of alcohol consumption considered to be safe and given how my body reacted when I have attempted the occasional 2-3 glasses of wine, I have made the very personal decision to avoid going there. Every now and again I do miss the social aspect of it, I miss the frivolity of the old me. Like most things post encephalitis and brain injury, it is a balancing act I suppose so whenever I chose to have alcohol, I prefer to keep to the one drink. The impact of going over this amount outweighs the positive so I feel like it’s just not worth it for me. I’m not judgmental of those who carry on, I actually used to be one of those person, but I hope that this blog helps those who may be puzzled by my decision to gain a better understanding of the ramifications of alcohol use post brain injury.
: Alcohol Think Again